老年偏瘫侧股骨颈骨折运用限制性内衬髋关节假体的疗效分析

doi:10.3969/j.issn.1003-9198.2022.11.014

摘要/Abstract

摘要： 目的探讨老年偏瘫侧股骨颈骨折病人采用限制性内衬髋关节假体的临床疗效。方法纳入2018～2020年收治的老年偏瘫侧股骨颈骨折病人共16例。采用Pinnacle ES限制性内衬全髋关节假体,对所有病人开展全髋关节置换术治疗。运用Harris髋关节评分、Fugl-Meyer评估量表(FMA)及Brunnstrom偏瘫运动功能分期评估术前及末次随访时的髋关节功能、偏瘫侧运动障碍严重程度及下肢功能,并记录随访期间出现的并发症。结果所有病例的手术时间为(54.7±8.3)min,术中出血量为(198.3±41.6)mL,随访时间为(15.7±3.1)个月。末次随访时的Harris评分比术前显著提高[(88.1±8.7)分比(17.4±2.6)分,P<0.05],关节功能优良率为93.75%。末次随访时的FMA评分、Brunnstrom偏瘫运动功能分期均明显改善(P<0.001)。随访期间在影像学上未见骨溶解、假体松动、下沉和假体周围骨折,1例(6.25%)病人出现腘静脉血栓并发症。结论运用限制性内衬髋关节假体治疗老年偏瘫侧股骨颈骨折能够有效改善髋关节及偏瘫侧肢体功能,降低术后假体脱位率,临床疗效肯定。

关键词: 偏瘫, 股骨颈骨折, 脱位, 髋关节置换, 限制性内衬

Abstract: Objective To investigate the clinical effect of limited lined hip prosthesis in the elderly patients with femoral neck fracture of hemiplegic side. Methods A total of 16 elderly patients suffering from femoral neck fracture of hemiplegic side from 2018 to 2020 in our hospital were enrolled. Pinnacle ES limited lined total hip prosthesis was used for total hip replacement in all patients. The hip function was evaluated by Harris hip score, and the severity of hemiplegic side motor disorder was evaluated by Fugl-Meyer Assessment Scale (FMA), and the hemiplegic lower limb function was evaluated by Brunnstrom staging. The complications during follow-up were recorded. Results The average operation time was 54.7±8.3 min and the average intraoperative bleeding was 198.3±41.6 mL. The average follow-up time was 15.7±3.1 months. The Harris hip score at the last follow-up was significantly higher than that before operation (88.1±8.7 vs 17.4±2.6, P <0.05). The excellent and good rate of hip function was 93.75%. The FMA score at the last follow-up was significantly higher, and the motor function stage of Brunnstrom was significantly higher (P<0.001) than those before operation. During the follow-up, osteolysis, prosthesis loosening, sinking and periprosthetic fractures were not found. Popliteal vein thrombosis occurred in one patient (6.25%). Conclusions The treatment of limited lined hip prosthesis for femoral neck fracture in the elderly with hemiplegia can effectively improve the function of hip joint and hemiplegic side limb, and can reduce the postoperative dislocation rate of prosthesis.

Key words: hemiplegia, femoral neck fracture, dislocation, hip replacement, restrictive lining

中图分类号:

R687.3

张理, 张凯彬, 秦然, 潘竹, 宋华荣. 老年偏瘫侧股骨颈骨折运用限制性内衬髋关节假体的疗效分析[J]. 实用老年医学, 2022, 36(11): 1137-1140.

ZHANG Li, ZHANG Kai-bin, QIN Ran, PAN Zhu, SONG Hua-rong. Effect of limited lined hip prosthesis on femoral neck fracture in elderly patients with hemiplegia[J]. Practical Geriatrics, 2022, 36(11): 1137-1140.

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